New York's approach to prison mental health care is structurally unique in this series: the New York State Department of Corrections and Community Supervision (DOCCS) does not manage mental health care internally or through a private contractor. Instead, it partners with an entirely separate state agency -- the New York State Office of Mental Health (OMH) -- which embeds its own clinical staff in DOCCS facilities to provide all mental health services across a six-level continuum of care.
This DOCCS-OMH partnership means that mental health clinicians working in New York state prisons are OMH employees, not DOCCS employees and not private contractors. OMH sets clinical standards, staffs the mental health programs, and operates residential mental health treatment units within DOCCS facilities under a formal interagency arrangement.
New York also has a statutory Serious Housing Unit (SHU) Exclusion Law (effective July 1, 2011) embedded in Correction Law § 137, which prohibits placing prisoners designated as seriously mentally ill (SMI) in long-term solitary confinement and instead requires placement in residential mental health treatment units.
More than 14,000 of the approximately 32,500 people in New York state prisons have been identified as having a mental illness.
New York does not have active federal court oversight of DOCCS mental health care at this time.
What New York Prisoners Are Entitled To
Under Estelle v. Gamble (1976), Correction Law § 137, and the DOCCS-OMH partnership:
- Mental health screening at reception and throughout incarceration, assessed by OMH staff.
- Assignment to facilities where the appropriate level of mental health service is available.
- For those designated SMI: placement in a residential mental health treatment unit rather than the Special Housing Unit (solitary).
- At residential mental health treatment unit placement: at least 4 hours per day of structured out-of-cell therapeutic programming and/or mental health treatment (excluding weekends and holidays), plus exercise.
- Crisis intervention, individual counseling (short- and long-term), group counseling, and special programs through OMH.
- Parole Support and Treatment Program (PSTP) for parolees with SMI upon release.
Mental Health Screening at Intake
Upon reception into the DOCCS system, all incoming prisoners are assessed by OMH staff to determine the amount of mental health services required. They are then assigned to facilities where that level of service is available. OMH assigns each prisoner to one of six mental health service levels based on the assessment.
If your person has a psychiatric history, provide documentation at reception -- prior hospitalizations, diagnoses, and active medications. The OMH assessment determines the service level and drives facility placement.
The DOCCS-OMH Partnership
The Office of Mental Health (OMH) is a separate New York State agency that operates the state's public mental health system, including state psychiatric centers. Under its DOCCS partnership, OMH:
- Embeds clinical staff (psychiatrists, psychologists, social workers, nurses) at DOCCS facilities.
- Provides all mental health clinical services within DOCCS prisons.
- Sets clinical standards for mental health care.
- Operates Residential Mental Health Treatment Units (RMHTUs) within DOCCS facilities.
- Assesses and assigns prisoners to OMH service levels.
- Partners with DOCCS on the Parole Support and Treatment Program (PSTP).
This arrangement means the mental health care your person receives in a New York prison is delivered by a state health agency (OMH), not by DOCCS security staff and not by a private company. Clinical decisions are made by licensed OMH clinicians.
The Six Levels of Mental Health Care
OMH assigns prisoners to one of six service levels (1 through 6) based on mental health assessment, from most intensive to least:
Level 1: The highest level of mental health service within DOCCS. Facilities designated OMH Level 1 have full Intermediate Care Programs (ICP). Level 1 facilities include a number of New York's major prisons.
Level 2: Intermediate level of service.
Level 3: Moderate level of service.
Level 4: Lower level of service.
Level 5: Minimal level of service.
Level 6: No assigned OMH staff. Facilities at Level 6 have a procedure in place for prisoners to request mental health services, which are then accessed through DOCCS Directive 4301.
Assignment to facilities at the appropriate level: When an OMH assessment determines the level of mental health services a prisoner needs, they are assigned to a facility where that level is available. Prisoners with higher mental health needs are housed at Level 1 or Level 2 facilities.
Residential Mental Health Treatment Units
New York's residential mental health treatment units are the specialized housing settings within DOCCS for SMI prisoners and others with significant mental health needs. These units are operated by OMH within DOCCS facility perimeters. Types of residential mental health treatment units:
Behavioral Health Unit (BHU): A residential unit with an emphasis on cognitive and behavioral interventions. The BHU is located at Great Meadow Correctional Facility (Phase 1, 38 beds; also Phase 2 with additional beds). Designed for prisoners with SHU sanctions -- it provides treatment-based housing as an alternative to solitary for SMI prisoners.
Residential Mental Health Treatment Units (RMHTU): General category for residential mental health treatment housing. At RMHTUs, SMI prisoners must be offered at least 4 hours per day of structured out-of-cell therapeutic programming and/or mental health treatment (excluding weekends and holidays), plus exercise.
Intermediate Care Program (ICP): Available at Level 1 facilities. ICP provides an intermediate level of care -- more intensive than outpatient but less intensive than inpatient psychiatric hospitalization.
Intensive Intermediate Care Program (IICP): The highest level of residential treatment within DOCCS, below a psychiatric hospital transfer.
OMH Level 1 facilities with ICPs include: Albion, Attica, Auburn, Bedford Hills, Clinton, Elmira, Fishkill, Five Points, Great Meadow, Green Haven, Mid-State, Sing Sing, and Sullivan.
Group Therapy Programs (GTP): Located at Elmira and Wende Correctional Facilities. Each site has 6 therapeutic cubicles and offers 2 hours/day, 5 days/week of out-of-cell therapeutic programming, with an emphasis on psychiatric and behavioral interventions.
The SHU Exclusion Law (Correction Law § 137)
The SHU Exclusion Law (effective July 1, 2011, embedded in Correction Law § 137(6)) prohibits placing seriously mentally ill prisoners in long-term Special Housing Unit (SHU) confinement. Key provisions:
- Prisoners designated SMI by OMH must be offered a heightened level of care in residential mental health settings.
- If an SMI prisoner receives a disciplinary sanction that would normally result in SHU placement, they are instead placed in a residential mental health treatment unit (BHU, RMHTU, ICP, or IICP as appropriate).
- Prisoners at RMHTUs must receive at least 4 hours/day of structured out-of-cell programming.
SMI designation is critical: it must be made and maintained by OMH clinical staff. A known vulnerability in the system: prisoners who have an SMI designation may lose it if their diagnosis is changed by a new OMH provider or if they appear stable at a given moment -- even though the underlying condition (schizophrenia, bipolar disorder) has not resolved. New York State Senate bill S905 (introduced 2025) addresses this by proposing that prisoners with qualifying diagnoses retain SHU Exclusion protections even if a later OMH clinician changes or removes the diagnosis.
DOCCS Directive 4301
DOCCS Directive 4301 governs how OMH services are accessed within DOCCS facilities. It establishes the procedure through which prisoners can request and receive mental health services at all facilities, including Level 6 facilities that do not have assigned OMH staff.
OMH State Psychiatric Centers
When a prisoner's needs exceed what the DOCCS residential mental health treatment units can provide, OMH can transfer them to an OMH-operated state psychiatric center for inpatient psychiatric care. OMH operates 23 psychiatric centers across New York State, which serve both civil and forensic populations.
The Parole Support and Treatment Program (PSTP)
The Parole Support and Treatment Program (PSTP) is a joint DOCCS-OMH program that provides:
- Supported housing for parolees with serious mental illness.
- A blended case management program.
- Support for community reentry specifically for parolees with SMI.
- Links to appropriate services and supports.
PSTP connects eligible SMI individuals with supported housing and case management as they transition from DOCCS to the community under parole supervision. This is one of the more developed parole-era mental health support programs in this series.
DOCCS-OMH and Correctional Association of New York
The Correctional Association of New York (CANY) is a longstanding independent nonprofit with a legislative mandate to inspect New York state prisons and report publicly on conditions. CANY's 2024 policy agenda identifies several mental health-related bills including expanded reentry mental health services, uniform electronic health records (EHR), and transitional accountability plans that include mental health discharge planning.
What Families Can Do
If your person is in DOCCS custody and has a mental illness:
Provide psychiatric history at intake. Supply documentation of prior hospitalizations, diagnoses, and active medications at reception. The OMH assessment at intake determines the service level and drives facility placement.
Know the OMH assessment and service level. Ask what OMH service level your person has been assigned (1 through 6). If they have significant mental health needs and have been assigned to a Level 4, 5, or 6 facility, ask whether a transfer to a Level 1 or 2 facility has been considered.
Know the SMI designation. Ask whether OMH has designated your person as seriously mentally ill (SMI). This designation is what triggers the SHU Exclusion Law protections. If they have SMI and are in SHU rather than a residential mental health treatment unit, document this and file a grievance.
Know the SHU Exclusion Law. Under Correction Law § 137(6), SMI prisoners must be placed in residential mental health treatment units rather than SHU. If your person has or has had an SMI qualifying diagnosis and is in SHU, file a grievance and contact Disability Rights New York.
Know the SMI diagnosis change risk. Per Senate bill S905 (2025), there is a documented problem of SMI prisoners losing their SHU exclusion protections when OMH providers change their diagnosis. If your person's SMI designation has been changed or removed and they have been placed in SHU, document this sequence and contact DRNY.
Know the 4-hour programming minimum. If your person is in a residential mental health treatment unit (BHU, RMHTU, ICP, IICP), they are entitled to at least 4 hours/day of structured out-of-cell therapeutic programming (excluding weekends/holidays). Document any failure to provide this programming.
Ask about PSTP. If your person has serious mental illness and is approaching parole, ask whether they have been assessed for the Parole Support and Treatment Program (PSTP), which provides supported housing and case management for parolees with SMI.
File a grievance. DOCCS has a grievance process. File formal grievances for: failure to conduct OMH assessment at intake, inappropriate service level assignment, SMI designation removal that results in SHU placement, failure to provide 4-hour daily programming in RMHTU, medication interruption, and failure to assess for PSTP.
Contact Disability Rights New York. DRNY (drny.org) is the federally mandated Protection and Advocacy organization for New York and monitors conditions for people with mental illness and disabilities in DOCCS facilities.
Contact the Correctional Association of New York. CANY (correctionalassociation.org) has a legislative mandate to inspect state prisons and accepts information from families and prisoners about conditions.
Seek legal help. If your person has an SMI designation or qualifying diagnosis and is in SHU, or if residential mental health treatment unit placement has been denied, consult a prisoner rights attorney with experience in New York's federal courts (Northern, Eastern, Southern, and Western Districts of New York).
Frequently asked questions
How does New York screen prisoners for mental illness?
Upon reception into DOCCS, all incoming prisoners are assessed by New York State Office of Mental Health (OMH) staff to determine the level of mental health services needed. OMH assigns each prisoner to one of six service levels (1 being most intensive, 6 being no assigned staff), and they are then assigned to facilities where that level of service is available. Provide psychiatric documentation at reception -- prior hospitalizations, diagnoses, and active medications.
Who provides mental health care in New York prisons?
Mental health care in DOCCS is provided entirely by the New York State Office of Mental Health (OMH) -- a separate state agency -- not by DOCCS directly and not by a private contractor. OMH embeds its own licensed clinical staff (psychiatrists, psychologists, social workers, nurses) at DOCCS facilities. This DOCCS-OMH partnership is unique in this series and means all mental health clinical decisions are made by licensed OMH clinicians, not corrections staff.
What are NY's six prison mental health levels of care?
OMH assigns prisoners to one of six service levels: Level 1 (highest -- full residential treatment programs including ICP at facilities such as Attica, Auburn, Bedford Hills, Clinton, Elmira, Fishkill, Green Haven, Sing Sing, Sullivan, and others); Level 2 (high); Level 3 (moderate); Level 4 (lower); Level 5 (minimal); Level 6 (no assigned OMH staff, but with a procedure for requesting services under DOCCS Directive 4301). Assignment drives facility placement.
What are DOCCS residential mental health treatment units?
DOCCS operates four types of residential mental health treatment units for SMI prisoners within facility perimeters: the Behavioral Health Unit (BHU, at Great Meadow -- for prisoners with SHU sanctions); Residential Mental Health Treatment Units (RMHTU -- general category); Intermediate Care Program (ICP -- at Level 1 facilities); and Intensive Intermediate Care Program (IICP -- highest intensity within DOCCS). Group Therapy Programs (GTP) operate at Elmira and Wende (2 hours/day, 5 days/week).
What is New York's SHU Exclusion Law for SMI prisoners?
The SHU Exclusion Law (effective July 1, 2011, Correction Law § 137(6)) prohibits placing SMI-designated prisoners in long-term Special Housing Unit (solitary) confinement. Instead, prisoners with an SMI designation who would otherwise go to SHU for disciplinary sanctions must be placed in residential mental health treatment units (BHU, RMHTU, ICP, or IICP as appropriate). SMI prisoners in RMHTUs are entitled to at least 4 hours/day of structured out-of-cell therapeutic programming (excluding weekends and holidays).
What programming do mental health treatment units provide?
Residential mental health treatment units are required to offer at least 4 hours/day of structured out-of-cell therapeutic programming and/or mental health treatments (excluding weekends and holidays), plus exercise. Programming focuses on cognitive and behavioral interventions (BHU), psychiatric and behavioral interventions (GTP), and intermediate care with individualized treatment (ICP/IICP). The focus is on therapeutic engagement rather than isolation.
What is the Parole Support and Treatment Program in NY?
The Parole Support and Treatment Program (PSTP) is a joint DOCCS-OMH program providing supported housing and blended case management for parolees with serious mental illness to facilitate community reentry. PSTP links eligible parolees with appropriate services and supports during the transition from DOCCS custody to community supervision. If your person has SMI and is approaching parole, ask whether PSTP assessment has been initiated.
How does New York handle mental health care at release?
DOCCS-OMH coordinates reentry for prisoners with mental illness through the Parole Support and Treatment Program (PSTP, for SMI parolees), collaboration with Community Reentry Task Forces (CRTFs), and discharge planning. DOCCS parole officers are assigned immediately upon release. Pending legislation (2024 CANY agenda) would require mental health reentry services as part of transitional accountability plans and mandate Medicaid enrollment and medical records transfer at release.
What can families do if mental health care is denied in NY?
Provide psychiatric documentation at reception for the OMH intake assessment. Know your person's OMH service level (1-6). Know the SMI designation -- this is the gateway to SHU Exclusion Law protections. If they are SMI and in SHU, file a grievance. Know the risk of SMI designation removal (S905 issue) -- document any diagnosis change that results in SHU placement. If in RMHTU, know the 4-hour daily programming minimum. Ask about PSTP for SMI parolees. File DOCCS grievances for level misassignment, SHU exclusion violations, and programming failures. Contact Disability Rights New York (drny.org) or CANY (correctionalassociation.org).
Who oversees mental health care in New York prisons?
The New York State Office of Mental Health (OMH) provides all clinical mental health services in DOCCS prisons under the DOCCS-OMH partnership. OMH is a separate state agency with its own clinical standards and staff. Disability Rights New York (DRNY, drny.org) is the federally mandated P&A organization monitoring conditions for people with mental illness and disabilities in DOCCS. The Correctional Association of New York (CANY) has a legislative mandate to inspect state prisons and report publicly on conditions. ---